Creative Solutions for Healthcare Improvement

"Make sure you get sufficient rest and play—the best ideas often happen when you are relaxing," recommends Dr Pritzker.

It can be cogently argued that the US healthcare system needs some fixing.

A massive, sprawling, ever-voracious head of snakes costing us $3.2 trillion annually and now constituting nearly 18% of our gross national product,1 the US healthcare system could surely benefit from some creative ideas.

The problem is, health care in this country has become corporatized and highly politicized. It's controlled largely by lobbyists working for big-money interests, and there is tremendous inertia and resistance to change. Simply stated, no one wants to lose his or her slice of the pie.

Most physicians, nurses, and other healthcare professionals aren't thrilled with how things are going, nor are government officials, business leaders, and other industry stakeholders. Least of all satisfied perhaps is the person who should be at the very center of our healthcare system—the patient. Today's healthcare consumers have become unwitting pawns in a giant chess game over which they have little or no control. No wonder so many of us feel increasingly frustrated and powerless.

But there is an answer that can free us from the quagmire—creativity.

While most of us think of creativity as something reserved for music, writing, theater, cinema, painting, dance, or theoretic physics at the highest level (eg, Einstein's theory of relativity), creativity is in fact a viable tool that both individuals and organizations can use daily to improve their performance and competitive advantage. And whether we can hear it or not, the US healthcare system is crying out for less sameness, less status quo, and more creativity.

To learn more about this highly potent and largely underutilized tool, I turned to one of the nation's foremost authorities on creativity, Steven R. Pritzker, PhD, professor, founder, and former director of Creativity Studies Specializations, Saybrook University, San Francisco, and coeditor-in-chief of The Encyclopedia of Creativity.2

Dr Cooper: First, can you please define creativity for me? What's the best definition?

Dr Pritzker: Sure. Anything new and useful. If it's new but not useful, it's not creative. And if it's useful but lacking newness, it doesn't qualify as creative either.

Dr Cooper: The problems facing our current healthcare system are large and pressing. How can something with such a simple definition help [those of] us employed in health care find our way out of the morass?

Dr Pritzker: Creativity in and of itself doesn't have to do anything. Quite frankly, creativity doesn't care whether it gets used or not. Nor does it have a moral imperative one way or the other. It wears no white halo or devil's horns. There have certainly been many examples in history of dark uses of creativity. The development of the atomic bomb, which was dropped on Hiroshima, is but one example of creativity put to destructive use.

On the other hand, the potential positive uses of creativity in medicine and within the healthcare industry in general are truly without limit. This is a largely untapped resource, full of promise and opportunity.

I, for one, would like to see a course on creativity incorporated into the curriculum at every single medical school in the country. It would teach the doctors of tomorrow so much about themselves and about problem-solving techniques they could use daily, no matter what their eventual medical specialty. They could also learn how to prescribe creativity as a drug-free alternative or adjunctive treatment for a wide variety of conditions, including PTSD [post-traumatic stress disorder], schizophrenia, adolescent behavioral problems, and even terminal illness.

Dr Cooper: What are the factors that serve to undermine our ability to be more creative, and how can we get past the obstacles to fashion a healthcare system that will be of greater benefit to all?

Dr Pritzker: The factors are many. I would say openness is the most important attribute or ingredient needed. We must be open to change before change can occur.

Other countries seem to achieve better preventive care and lower morbidity and mortality at far less cost than we see in the US. What has prevented us, I think, from adopting similar approaches is the entrenched interests out there. As long as our legislators are influenced more by lobbying groups than by what is best for patients, nothing substantial will change.

Dr Cooper: Some maintain that our current health insurance-driven models of health care delivery create perverse incentives that put too much emphasis on the “money” or reimbursement aspect of care. But just merely whisper the words “single payer” to many folks and you are likely to get slapped in the face, or worse.

Dr Pritzker: Or worse—definitely. But here's the thing—most of these health insurance companies are for-profit enterprises that must answer to their board members and shareholders. And having a profit motive where people's lives are at stake creates a moral conflict of interest and an endangerment of people's lives.

Health care, in my opinion, should not be a for-profit enterprise—it should be based on the needs of the patient.

Now there are many excellent and compassionate physicians who are designing better models of care—ways to meet the health care needs of more people with enhanced greater quality and cost-effectiveness. These doctors are to be congratulated and lauded for their creative initiative. It is my sincere hope that more doctors will follow their lead in engineering creative solutions to the problems plaguing our healthcare system. There are other systems of care that can work, and which perhaps should work, but fear and lack of openness to change are 2 of the biggest factors standing in the way of creativity.

Strong incentives are needed to tip the scales back in favor of the patient and the doctor-patient relationship. Unfortunately, we may need new laws or legislation to make it all work, and we've already seen what a bitter pill this is to swallow for many inside the Beltway.

Dr Cooper: What can be done to improve the ever-exasperating EMR [electronic medical record]? As you know, many doctors lament the fact that EMRs are overly complicated and unwieldy and tend to detract substantially from the time they can spend with their patients

Dr Pritzker: One thought that comes to mind is that physicians should be intimately involved in their design and in all stages of their implementation—from A to Z and back again to A. Although I do not personally use EMRs, many of my colleagues in the fields of clinical psychology and psychiatry tell me that these EMRs are built more for the bean counters and billing people than for the doctors and patients. In other words, they are needed to generate diagnosis codes and tracking for payment. They track other things, too, of course, but they often put clicking boxes over patient care.

Dr Cooper: So maybe doctors should design their own systems—EMRs with fewer boxes to click and more heart?

Dr Pritzker: Sounds right to me. Maybe more heart and soul.

Dr Cooper: While many doctors are very creative individuals, either artistically or in the way they interact with patients and run their practices daily, many other doctors know very little about the topic. What would be your recommendation to them?

Dr Pritzker: The study of creativity will help them understand more about themselves as individuals. It will also help them be better at what they do. Problem solving is a large part of the job. And learning about creativity and how it works will help them improve their performance.

I would love for all physicians to explore some of the literature on creativity and see how it applies to themselves and their work. I think they would find it worthwhile on both a personal and professional level.

Dr Cooper: What can physicians try right now to enhance creativity in their own lives, in their own practices? Any tips or suggestions you'd care to impart?

Dr Pritzker: Yes, absolutely. Here are 5 suggestions:

Consciously think about areas in your personal and professional life that could be creatively improved—be open to viewing your life, your practice, and your organization as something that is flexible rather than fixed.

Become more aware of your everyday creativity. Improvise when you approach routine tasks.

Work with colleagues to solve problems and innovate with the intention of challenging the status quo.

Take a disciplined professional approach to creativity and problem solving—set aside a specific time every day to work on it.

Make sure you get sufficient rest and play—the best ideas often happen when you are relaxing.

Dr Cooper: Thank you very much, Dr. Pritzker, for a very illuminating and useful interview.

Dr Pritzker: And thank you for allowing me to communicate with your audience.

Dr Steven Pritzker is a teacher, researcher, writer, speaker, and creativity coach. He is coeditor-in-chief of The Encyclopedia of Creativity, a groundbreaking 2-volume work that provided the first comprehensive review of creativity research in many different domains. He was president and a fellow of Division 10 of The American Psychological Association (Psychology of Aesthetics, Creativity, and the Arts). Dr Pritzker was a founder and director of the Creativity Studies Specializations at Saybrook University, where he is a faculty member. Prior to earning his doctorate at University of Southern California, he wrote over 75 network television episodes for series including Emmy-winning Room 222 and The Mary Tyler Moore Show. He worked as a writer or writer/producer on over 200 network episodes for series including Breaking Away, Delvecchio, The Partridge Family, The Love Boat, Maude, Fish, Silver Spoons, and The Hogan Family.